Nasal septal hematoma is a rare and self-recognizable complication of nasal bone fracture: A retrospective study
Year: 2025
Type: article
Study design: Observational Study
Abstract: PURPOSE: Nasal septal hematoma (NSH) is a rare but potentially severe complication which can occur after nasal bone fracture (NBF). A subperichondrial accumulation of blood in the nasal septum can lead to breathing difficulties, infections and nasal deformities. To prevent such complications our department's standard operating procedure requires clinical exclusion of NSH both on the day after NBF and the day after nasal bone repositioning. These repeated appointments create a high organizational effort in the outpatient department. The aim of this study was to assess the incidence of NSH after NBF and nasal bone repositioning in our patient population and thus to evaluate the necessity of repeated follow-up examinations. METHODS: In this retrospective study patients diagnosed with NBF over a nine-year period (January 2015 - June 2024) were included (n = 675). We assessed the presence of NSH, nature of trauma, pre-existing conditions (especially coagulopathies) and the clinical course. RESULTS: NSH was diagnosed in 0.6 % of cases (n = 4). The NSH-incidence after nasal bone repositioning was n = 0. There was no significant correlation between coagulopathy or anticoagulant therapy and the incidence of NSH (p = 1). Painful septal swelling combined with nasal obstruction was exclusively observed in NSH-patients (n = 4, 100 %). CONCLUSION: The incidence of post-traumatic and post-interventional NSH in our population is negligible. Affected patients showed specific clinical features. Therefore, routine follow-ups appear not be justified given the organizational effort. Instead, emphasis should be placed on counseling patients to recognize signs of NSH that require immediate reevaluation.
Institutions: Goethe University Frankfurt, University Hospital Frankfurt
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: gold
Estimated APC paid: $3,630
OpenAlex ID: W4415554444